European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Balloon kyphoplasty (BKP) with calcium phosphate cement (CPC) is increasingly being used for spinal surgery in younger patients. In routinely performed follow-up CT scans we observed considerable areas of demineralization in CPC processed vertebrae in several patients. To rule out infections or inflammations histological examinations were planned for these patients. ⋯ CPC demonstrated good biocompatibility and osseointegration in clinical use, with no evidence of inflammation or osteonecrosis. Demineralized areas in CT scans could be a result of remodeling of the cancellous bone in vertebral bodies.
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The decision of when to use selective thoracic fusion (STF) and the prediction of spontaneous lumbar curve correction (SLCC) remain difficult. Using a novel methodological approach, the authors yielded for a better prediction of SLCC and analyzed the efficacy of anterior scoliosis correction and fusion (ASF). ⋯ After analyzing a sufficiently large sample of 273 patients who underwent ASF for STF, significant predictors for SLCC were established and reported according to the surgical outcomes. Application of the prediction models can aid surgeons in the decision-making process regarding when to perform STF. Our results indicate that with stratification of outcomes into target curves (e.g., an LC <20°), future benchmarks for STF might be more conclusive.
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To determine fusion necessity to one level below lower-end vertebra (LEV+1) in selective posterior fusion of moderate thoracolumbar/lumbar (TL/L) idiopathic scoliosis. ⋯ Our analysis almost showed no benefit for fusing to LEV+1 in moderate TL/L idiopathic scoliosis patients undergoing posterior selective fusion with pedicle screws. For patients with TL/L Cobb angle more than 60°, the distal fusion level probably needs to be LEV+1.
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Lumbar spinal stenosis (LSS) is commonly assessed on MRI by measuring dural sac cross-sectional area (DSCA). A new method, morphological grading A-D, has recently been introduced as an alternative method. ⋯ The study shows that the inter- and intraobserver agreements of DSCA and morphological grading A-D were acceptable and their intercorrelation is strong. Both methods may be used in the MRI evaluation of LSS.
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The purpose of this study was to examine radiographic and clinical outcomes in the treatment of adult degenerative scoliosis using a minimally invasive (MI) lateral approach for anterior lumbar interbody fusion (IBF). ⋯ MI lateral IBF in the treatment of degenerative scoliosis results in lower complication rates and clinical and radiographic outcomes equivalent to reports in the literature of conventional approaches.